scholarly journals Clinical Study on the Etiology of Postthyroidectomy Skin Sinus Formation

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Shan Jin ◽  
Wuyuntu Bao ◽  
Oyungerel Borkhuu ◽  
Yun-Tian Yang
Keyword(s):  
Thyroid Surgery ◽  
Treatment Options ◽  
Postoperative Infections ◽  
Complete Excision ◽  
Aseptic Processing ◽  
Sinus Formation ◽  
Surgical Suture ◽  
Technical Advances ◽  
Medical University ◽  
Postoperative Administration

Background. Thyroidectomy is one of the most frequently performed surgical procedures worldwide. Despite technical advances and high experience of thyroidectomy of specialized centers, it is still burdened by a significant rate of postoperative complications. Among them, the skin sinus formation is an extremely rare postthyroidectomy complication. Here, we first report the incidence of the skin sinus formation after thyroidectomy to identify the causes for skin sinus formation after thyroidectomy and to discuss its prevention and treatment options.Methods. A retrospective analysis was carried out of patients who underwent excision operation of fistula for postthyroidectomy skin sinus formation. Data were retrieved from medical records department of the Affiliated Hospital of Inner Mongolia Medical University.Results. Of the 5,686 patients who underwent thyroid surgery, only 5 patients (0.088%) had developed skin sinus formation. All 5 patients successfully underwent complete excision of fistula.Conclusion. Infection, foreign body, thyroid surgery procedure, combined disease, and iatrogenic factors may be related with skin sinus formation after thyroidectomy. To reduce the recurrence of postoperative infections and sinus formation, intra- and postoperative compliance with aseptic processing, intraoperative use absorbable surgical suture/ligature, repeated irrigation and drainage, and postoperative administration of anti-inflammatory treatment are to be followed.

scholarly journals Tumor Reduction with Pazopanib in a Patient with Recurrent Lumbar Chordoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Maurício Fernando Silva Almeida Ribeiro ◽  
Micelange Carvalho de Sousa ◽  
Samir Abdallah Hanna ◽  
Marcos Vinicius Calfat Maldaun ◽  
Ceci Obara Kurimori ◽  
...  
Keyword(s):  
Kinase Inhibitors ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Axial Skeleton ◽  
Low Grade ◽  
Complete Excision ◽  
Systemic Treatments ◽  
Tumor Reduction ◽  
Comprehensive Genomic Profiling ◽  
Multifocal Recurrence

Introduction. Chordomas are rare malignancies of bone origin that occur in the axial skeleton, typically the skull base and lumbar/sacral regions. Although often classified as low-grade neoplasms, its locally infiltrative behavior may result in significant morbidity and mortality. Optimal surgical resection may be curative, but up to 50% of the cases relapse within 5 years, and currently there are no systemic treatments approved in this setting. A large proportion of these tumors express stem-cell factor receptor (c-KIT) and platelet-derived growth factor receptors (PDGFRs), providing a rationale for the use of tyrosine-kinase inhibitors (TKIs). Case report. A 27-year-old male presented with recurrent chordoma of the lumbar spine 4 years after initial diagnosis. Salvage therapies in the interval included repeat resections and radiation therapy. He ultimately developed multifocal recurrence not amenable to complete excision or reirradiation. A comprehensive genomic profiling assay was performed and revealed nondrugable alterations. Decision was made to proceed with systemic treatment with pazopanib 800 mg/day, resulting in tumor reduction (−23.1% reduction in size) and prolonged disease control. Conclusion. For this patient with a multiple recurrent chordoma and limited treatment options, pazopanib resulted in sustained clinical benefit following initial tumor reduction.

scholarly journals Type VI Choledochal Cysts—Case Report and Review of Literature

2019 ◽  
Vol 05 (03) ◽  
pp. e82-e86 ◽  
Author(s):  
J. M. V. Amarjothi ◽  
Villalan Ramasamy ◽  
Jeyasudhahar Jesudasan ◽  
O. L. NaganathBabu
Keyword(s):  
Hepatic Duct ◽  
Treatment Options ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Interesting Case ◽  
Common Hepatic Duct ◽  
Choledochal Cysts ◽  
Middle Aged ◽  
Complete Excision ◽  
Intrahepatic Bile Ducts ◽  
Aged Woman

AbstractCholedochal cysts (CDC), are rare congenital dilations involving the extra hepatic biliary apparatus with or without dilation of the intrahepatic bile ducts. They are conventionally classified into five types. A new type, type VI, causing dilation of the cystic duct between the neck of the gall bladder and the common hepatic duct (CHD) has been described in medical literature which is the rarest of all these subtypes. They are commonly observed in middle aged females and are mostly symptomatic. Most of these cysts need magnetic resonance cholangiopancreatography (MRCP) for accurate diagnosis. Treatment options for these lesions are not well defined but range from simple cholecystectomy to complete excision of the entire bile duct and biliary reconstruction, as there is a concern of malignant transformation in these cysts. Hence, these rare cysts, though rare, must be borne in mind when dealing with suspicious cystic lesions in the biliary tract. Here, we present an interesting case of such a rare cyst and its management in a middle aged woman.

scholarly journals Endoscopic Total Thyroidectomy: Report of Two Cases

1970 ◽  
Vol 26 (1) ◽  
pp. 46-49
Author(s):  
M Mohibul Aziz ◽  
MA Wohab Khan ◽  
Shamin Islam
Keyword(s):  
Total Thyroidectomy ◽  
Key Words ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Harmonic Scalpel ◽  
Endoscopic Thyroidectomy ◽  
Vocal Cord Palsy ◽  
Experienced Hand ◽  
Thyroid Swelling ◽  
Medical University

Two patients (one male and one female) recently under went total thyroidectomies using a standard laparoscope at the department of surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Three ports (one mid line and two laterals) were employed and a harmonic scalpel was used for the dissection. To the best of our knowledge, there was no report of endoscopic total thyroidectomy from Bangladesh. Both patients were fed on the first post operative day. They were discharged between the 3rd and 4th post operative days. There was no hypocalcaemia but one patient developed temporary unilateral vocal cord palsy. Endoscopic thyroidectomy appears to be a technically feasible patient friendly modality of treatment for the selected cases of thyroid swelling in an experienced hand with excellent out come. Key Words: Endoscopic; laparoscopic; thyroid surgery; total thyroidectomy. DOI: 10.3329/jbcps.v26i1.4233 J Bangladesh Coll Phys Surg 2008; 26: 46-49

scholarly journals Therapeutic Plasma Exchange in Guillain Barre Syndrome: An experience of Bangabanhu Sheikh Mujib Medical University, Bangladesh

2022 ◽  
Vol 4 (1) ◽  
pp. 11-13
Author(s):  
Sheikh Saiful Islam ◽  
Jannatul Ferdous ◽  
Ashraful Hoque ◽  
Atiar Rahman
Keyword(s):  
Plasma Exchange ◽  
Treatment Modality ◽  
Neurological Diseases ◽  
Treatment Options ◽  
Therapeutic Plasma Exchange ◽  
Guillain Barre Syndrome ◽  
Treatment Modalities ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Medical University

Background: Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh. Materials and Methods: A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume. Results: Out of 50 cases there were 43 (86%) male and 7 (14%) female.  Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE & 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered. Conclusion: The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.

How soon will the patient with metastasis return for radiosurgery?

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 82-85 ◽  
Author(s):  
Kotaro Nakaya ◽  
Motohiro Hayashi ◽  
Masahiro Izawa ◽  
Taku Ochiai ◽  
Tomokatsu Hori ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Standard Treatment ◽  
Small Cell Lung Carcinoma ◽  
Treatment Options ◽  
Single Session ◽  
Cell Lung Carcinoma ◽  
Almost All ◽  
Medical University ◽  
Median Interval

ObjectStereotactic radiosurgery for brain metastasis has become one of the standard treatment options in recent years. Some patients must undergo repeated stereotactic radiosurgery for new lesions. The authors retrospectively reviewed their data to estimate how soon the patients undergo repeated radiosurgery for new lesions.MethodsBetween October 1999 and March 2006, 1081 patients with brain metastases underwent Gamma Knife surgery (GKS) at Tokyo Women's Medical University. One hundred and forty-nine patients in whom GKS had been performed two or more times were evaluated. There were 68 men and 81 women with a median age of 61 years (range 29–90 years). The authors analyzed data on patient age, number of treated lesions, and period between GKSs. Follow-up imaging was performed in almost all patients every 2 to 3 months after GKS.The number of lesions treated in a single session varied from one to 35. The median interval between GKSs was 26 weeks (range 3–175 weeks) for patients with breast cancer and 23 weeks (range 4–179 weeks) for patients with non–small cell lung carcinoma.Conclusions It would appear that follow-up imaging studies should be obtained every 2 to 3 months after GKS to monitor patients for tumor recurrence.

scholarly journals Surgical management of aneurysmal bone cysts of the spine

2003 ◽  
Vol 15 (5) ◽  
pp. 1-7 ◽  
Author(s):  
James K. Liu ◽  
Douglas L. Brockmeyer ◽  
Andrew T. Dailey ◽  
Meic H. Schmidt
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Bone Destruction ◽  
Unknown Origin ◽  
Neurological Deficits ◽  
Bone Cysts ◽  
Complete Excision ◽  
Aneurysmal Bone Cysts ◽  
Special Factors

Object Aneurysmal bone cysts of the spine are benign, highly vascular osseous lesions of unknown origin that may present difficult diagnostic and therapeutic challenges. They are expansile lesions containing thin-walled, blood-filled cystic cavities that cause bone destruction and sometimes spinal deformity and neurological compromise. The treatment of aneurysmal bone cysts of the spine remains controversial according to the literature. In this review, the authors discuss the clinical manifestations, pathophysiological features, neuroimaging characteristics, and treatment strategies for these lesions. Methods Treatment options include simple curettage with bone grafting, complete excision, embolization, and radiation therapy. Reconstruction and stabilization of the spine may be warranted if deformity and instability are present. Special factors need to be considered in the management of these lesions. Conclusions Complete excision of aneurysmal bone cysts offers the best chance of cure and spinal decompression if neurological deficits are present.

scholarly journals Anterior thoracic intradural arachnoid cysts

1999 ◽  
Vol 6 (5) ◽  
pp. E10 ◽  
Author(s):  
Gerardo Caruso ◽  
Antonino Germanò ◽  
Mariella Caffo ◽  
Massimo Belvedere ◽  
Giovanni La Rosa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Treatment Options ◽  
Relevant Literature ◽  
Spastic Paraparesis ◽  
Treatment Strategies ◽  
Arachnoid Cysts ◽  
Complete Excision ◽  
Medline Search ◽  
Excellent Outcome ◽  
Intradural Arachnoid Cysts

Anterior thoracic intradural arachnoid cysts (ATIACs) are a rare cause of spinal cord and nerve root compression, for which different treatment strategies have been proposed. Although ATIAC represents a well-known clinical entity, the choice of surgical method has not been uniform, and no study has been specifically designed to compare the results of the different treatment options adopted. The authors report the case of a 40-year old man with a 1-year history of dorsal pain, weakness in the lower extremities, gait disturbance, and mild sexual and urinary dysfunction. On neurological examination spastic paraparesis, lower-extremity hypertonia, and hypesthesia below T-2 were demonstrated. Magnetic resonance imaging revealed the presence of an ATIAC at the T-2 level. The patient underwent complete microsurgical removal of the cyst. The authors conducted a Medline search of the relevant literature from 1966 to 1998 and also obtained data on other cases in which patients underwent surgical treatment of ATIAC. The literature search yielded five such cases. Treatment strategies were complete excision and fenestration followed by placement of a shunt. In addition, one case was characterized by intraoperative cyst rupture during retraction of the spinal cord. Correct preoperative workup coupled with microneurosurgical technique allow for successful removal of the lesion and excellent outcome. Based on the literature review and the results in our case, the complete excision of ATIAC is associated with an excellent outcome, which is different from results achieved using other surgical strategies.

scholarly journals Post-Operative Complications after Thyroid Gland Surgery due to Different Pathologic Condition: A Prospective Study

2021 ◽  
Vol 8 (2) ◽  
pp. 119-124
Author(s):  
Rana Jahangir Alam ◽  
Mohammad Salim ◽  
Sayem Al Monsur Faizi ◽  
Aklima Parvin ◽  
Farah Naz Amina ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Elective Surgery ◽  
Surgical Complication ◽  
Thyroid Disorders ◽  
Complication Rates ◽  
Biochemical Tests ◽  
Study Population ◽  
Thyroid Gland Surgery ◽  
A Prospective Study ◽  
Medical University

Background: The outcome and complication rates of post-operative cases are largely dependent on different factors. Objective: The objective of this study was to determine the risk factors responsible for major postoperative complications after thyroid surgery. Methodology: This was a prospective cohort study which was carried out at the Department of Surgery, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh. Adult patients undergoing elective surgery for various thyroid disorders were selected as study population. This study was carried out from March 2009 to June 2011 for a period of two years. The study was included patients of various thyroid disorders that required surgical intervention of different magnitude. They were evaluated by history, physical examination, biochemical tests, ultrasound scan and FNAC where indicated. Histopathology was done and patients were followed up for subsequent outcome. Results: Among 2(2%) of them developed reactionary haemorrhage. The most common immediate surgical complication following thyroidectomy is hypocalcaemia and 12 patients (12%) experiencing this problem. 11(11%) patients developed transient tetany (hypocalcaemia) on 2nd post-operative day which was improved later on and 1(1%) patient developed permanent hypoparathyroidism and the patient supplemented by vitamin-D more than 6 months follow-up . In this study the mortality rate is 0% and complication rate is acceptable in comparison to other study. Conclusion: Hypoparathyroidism is a relatively common complication after thyroid surgery. Journal of Current and Advance Medical Research, July 2021;8(2):119-124

scholarly journals In Vitro Evaluation of the activity of Ceftazidime-avibactam and Aztreonam-Avibactam against 76 Stenotrophomonas maltophilia isolates from a teaching hospital in Chongqing

2020 ◽  
Author(s):  
Qiuxia Lin ◽  
Hua Zou ◽  
Xian Chen ◽  
Menglu Wu ◽  
Deyu Ma ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Combined Therapy ◽  
Treatment Options ◽  
Clinical Isolates ◽  
Broth Microdilution ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Medical University ◽  
Selection Of

Abstract Background: Treatment options for Stenotrophomonas maltophilia (S. maltophilia) infections were limited. We assessed the efficacy of ceftazidime-avibactam (CAZ-AVI) and aztreonam-avibactam (ATM-AVI) against a selection of 76 S. maltophilia out of the 1179 strains isolated from the First Affiliated Hospital of Chongqing Medical University during 2011-2018. Methods: We investigated the antimicrobial resistance profiles of the 1179 S. maltophilia clinical isolates from the first affiliated hospital of Chongqing Medical University during 2011-2018, a collection of 76 isolates of which were available for further study of microbiological characterization. Minimum inhibitory concentrations (MICs) of ceftazidime (CAZ), ceftazidime-avibactam (CAZ-AVI), aztreonam (ATM) and aztreonam-avibactam (ATM-AVI) were determined via the broth microdilution method. We deemed that CAZ-AVI or ATM-AVI was more effective in vitro than CAZ or ATM alone when CAZ-AVI or ATM-AVI led to a category change from “Resistant” with CAZ or ATM alone to “Susceptible” or “Intermediate” with CAZ-AVI or ATM-AVI, or if the MIC of CAZ-AVI or ATM-AVI was at least 2-fold lower than the MIC of CAZ or ATM alone. Results: For the 76 clinical isolates included in the study, MICs of CAZ, ATM, CAZ-AVI and ATM-AVI ranged from 0.03-64, 1-1024, 0.016-64, and 0.06-64 μg/mL, respectively. In combined therapy, AVI was effective at restoring the susceptibility of 48.48% (16/33) and 89.71% (61/68) of S. maltophilia to CAZ and ATM, respectively. Furthermore, CAZ-AVI showed better results in terms of the proportion of susceptible isolates (77.63% vs.56.58%, P<0.001), MIC50 (2μg/mL vs. 8μg/mL, P<0.05), and MIC distribution (P<0.001) when compared to CAZ. According to our definition, CAZ-AVI was more effective in vitro than CAZ alone for 84.21% of the isolates. Similarly, ATM-AVI also showed better results in terms of the proportion of susceptible isolates (90.79%vs. 10.53%, P<0.001), MIC50 (2μg/mL vs. 64μg/mL, P<0.001), and MIC distribution (P<0.001) when compared to ATM. According to our definition, ATM-AVI was also more effective in vitro than ATM alone for 97.37% of the isolates. Conclusions: AVI potentiated the activity of both CAZ and ATM against S. maltophilia clinical isolates in vitro. We demonstrated that CAZ-AVI and ATM-AVI are both useful therapeutic options to treat infections caused by S. maltophilia.

scholarly journals Haemangioma of the Penis: A Review and Update of the Literature

2020 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Laser Treatment ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Surgical Excision ◽  
Vascular Lesion ◽  
Low Flow ◽  
Imaging Features ◽  
Complete Excision ◽  
Complete Surgical Excision ◽  
Perineal Region

Haemangioma of the penis (HOP) is a rare benign vascular lesion which can affect the penis of males including infants, children, and adults of up to the over 80 year-olds. HOP does manifest as: asymptomatic lump or lesion on the penis; localised pain or tenderness anywhere within the penis; a tumoral mass anywhere on the penis; pain in the penis on erection; curvature of penis on erection; bright red compressible papule or papules on penis; nodules on penis; plaques on penis; ulceration on penis; haemorrhage on penis. HOP may be associated erectile dysfunction in some cases and could affect voiding if it is associated with the urethral meatus. HOP which tends to be solitary in most cases may mimic other diseases of the penis as well as may be associated with haemangioma in the scrotum and perineal region occasionally. Diagnosis can be established by the clinical features and this can be reaffirmed by radiology imaging features with the use of Doppler ultrasound scan, CT scan and MRI scan which show low-flow within the lesion. Majority of the lesions tend to be superficial and not associated with the corpora cavernosa and spongiosum. There is no consensus opinion on the best treatment options hence various treatment options for HOP have been successfully utilized including: complete surgical excision, sclerotherapy, laser treatment, cryotherapy, and other therapies. Most cases of HOP do not recur but following sclerotherapy and laser treatment of large HOPs repeat procedures tend to be required and there may be residual / recurrent lesion that may need to be treated again. Deep and large HOPs may require complete excision with insertion of tunica graft. Very large HOPs could be more effectively treated by one stage complete surgical excision but the choice of the patient is important. The diagnosis of the lesion can be confirmed by the histopathology features of the lesion and positive immunohistochemistry staining for CD31 (strong), Factor VIII, and HHF35 (myopericytes) and minimal staining for CD34. HOP needs to be carefully differentiated from epithelioid angiosarcoma of the penis and epithelioid haemangioendothelioma. A multi-centre trial of various treatment options for HOP would be required to provide treatment guidelines for HOP taking into consideration the size of the lesion and availability of the various treatment options.

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